Abstract 10307: Development and Verification of a Comprehensive Model of Atherosclerosis for Risk Stratification with CTA
Introduction: The purpose of this study was to determine if detailed assessment of atherosclerosis using a comprehensive atherosclerotic plaque (CAP-CT) risk score Results in better differentiation of risk compared to standard CTA classification of the most severe lesion. Computed tomography coronary angiography (CTA) provides important prognostic information.
Methods: CTA was performed in 1439 patients (58% male, age 57±12 years). CTA scans were first graded as normal, non-significant (<50% stenosis), and significant (=50% stenosis). In addition, the CAP-CT risk score was developed incorporating plaque extent, severity, composition and location on a segment basis into a single score (0–42). During follow-up the composite endpoint of all cause mortality and non-fatal infarction was recorded.
Results: During follow-up (mean 2.3±1 years), an event occurred in 57 patients. The annualized event rate for patients with a normal CTA (n=514, 36%) was 0.6%, 1.3% for non-significant CTA (n=483, 34%) and 3.7% for significant CTA (442, 31%). In patients with a CAP-CT risk score <6 (n=801, 56%) the event rate was 0.7%, 2.4% in patients with a CAP-CT score 6–21 (n=537, 37%), and 6.9% in patients with a score >21 (n=101, 7%). Compared to standard CTA classification the CAP-CT risk score resulted in 43% total reclassification of risk.
Conclusion: Integration of detailed plaque characteristics on CTA into a single risk score provides a good discrimination between low, high and very high risk for events. Implementation of the CAP-CT risk score resulted in better differentiation of risk compared to standard CTA classification of the most severe lesion.
- © 2010 by American Heart Association, Inc.